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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

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Pediatric endoscopic dacryocystorhinostomy.

Chris E de Souza¹, Jayesh Nisar, Rosemarie A de Souza

¹Lilavati Hospital, Holy Family Hospital and Tata Memorial Hospital, Mumbai, India. chris.desouza1@gmail.com

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery

|May 5, 2012

Summary

Endoscopic dacryocystorhinostomy by removing the medial wall of the lacrimal sac (LS) is effective for treating chronic epiphora in children. This procedure showed a high success rate in resolving symptoms and preventing dacryocystitis attacks.

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Area of Science:

Ophthalmology
Pediatric Surgery

Background:

Chronic epiphora and dacryocystitis in children can significantly impact quality of life.
Endoscopic dacryocystorhinostomy (DCR) is a surgical option for these conditions.

Purpose of the Study:

To evaluate the efficacy of endoscopic dacryocystorhinostomy, specifically removal of the medial wall of the lacrimal sac (RMW of LS), in treating pediatric epiphora.
To assess the success rates and outcomes of this surgical technique.

Main Methods:

A case series involving a chart review of 37 children who underwent RMW of the LS between 1997 and 2010.
Two additional patients with external fistulae and cicatrized lacrimal sacs (LS) received lacrimal stents.

Main Results:

95% of children (37) underwent RMW of the LS, with 92% achieving successful outcomes (patent neofistula) after 12 weeks.
8% of neofistulae required revision due to obstruction within 2 weeks.
Stenting for patients with fistulae and cicatrized LS provided temporary relief, with epiphora returning after stent removal.

Conclusions:

Removal of the medial wall of the lacrimal sac via endoscopic dacryocystorhinostomy is an effective treatment for chronic epiphora in children.
The procedure demonstrates a high success rate in achieving long-term symptom resolution.